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Agathon is offline Agathon
Prince
Leafs 4TW!! - CPA
Dec 2002
time: 00:16
  Old Post 23-12-2004 09:25
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If you want to stop this sort of free riding Berz, you will need an agency with the power to compel people to pay for the risks they expose others to. To be effective this agency will be suspiciously like a government.

Lung is offline Lung
King
of my princess Anastasia!
Mar 1999
time: 15:16
  Old Post 23-12-2004 09:25 Visit Lung's homepage!
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How do you get private enterprise to give money away??

Agathon is offline Agathon
Prince
Leafs 4TW!! - CPA
Dec 2002
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  Old Post 23-12-2004 09:27
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quote:
However, as Agathon said given the state of our society there is no reason we can not provide BASIC medical care for everone. Flu vacinations count, hip replacements don't.


I don't know about that. People with ****ed hips aren't much good at work and slow me down when I am trying to get down the escalator. Plus, I don't like seeing people crippled.

I guess that's why I'm prepared to pay taxes to fund things like wheelchair ramps, so that people with disabilities can live happy and productive lives rather than being stuck inside for 50 years.

Agathon is offline Agathon
Prince
Leafs 4TW!! - CPA
Dec 2002
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  Old Post 23-12-2004 09:28
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quote:
How do you get private enterprise to give money away??


By having the state, which has a monopoly on force. Hobbes pointed this out over 300 years ago. We give up some of our liberty to the state in order to preserve the rest of it, for with complete market liberty we would end up in a state of nature.

Agathon is offline Agathon
Prince
Leafs 4TW!! - CPA
Dec 2002
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  Old Post 23-12-2004 09:29
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quote:
But that is okay Save, go exercise your "right" to bus service, and have fun excercising your "right" to use the Interstates.


Why shouldn't buses be free, if it is cheaper to fund them collectively than it is to spend millions and millions of dollars on pollution belching cars?

Agathon is offline Agathon
Prince
Leafs 4TW!! - CPA
Dec 2002
time: 00:16
  Old Post 23-12-2004 09:34
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quote:
but our health care would fall to the quality of nations such as Canada.


You mean fall up??

Canadians are on the average healthier than Americans and pay far less as a %age of GDP than the US to provide health care to every single Canadian.

Hint: there's nothing wrong with Canadian health care compared to the US.

Hint 2: Canada has a much lower rate of violent crime too.

Hint 3: It might have something to do with the US being totally wrong about how to solve these problems, not with anything bad the Canadians have done.

Patroklos is offline Patroklos
Warlord
Back home in good ole Norfolk VA
Dec 2001
time: 05:16
  Old Post 23-12-2004 09:35
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quote:
Why shouldn't buses be free, if it is cheaper to fund them collectively than it is to spend millions and millions of dollars on pollution belching cars?


I agree, but it is not some "right" that you must be afforded. When cities get in budget crunches they suspend bus services. When an interstate needs repair, they close it. It is a service, which becuase society is capable of supporting it they do so as a service to the public.

Patroklos is offline Patroklos
Warlord
Back home in good ole Norfolk VA
Dec 2001
time: 05:16
  Old Post 23-12-2004 09:36
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quote:
Canadians are on the average healthier than Americans and pay far less as a %age of GDP than the US to provide health care to every single Canadian.


That has nothing to do with their inferior health care system, it is because they have a healthier lifestyle.

Agathon is offline Agathon
Prince
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Dec 2002
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  Old Post 23-12-2004 09:41
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quote:
That has nothing to do with their inferior health care system, it is because they have a healthier lifestyle.


Have you been to a Canadian donut shop lately? Or had a plate of poutine? Or one of those bagels with half a ton of cream cheese in the middle? And everything here is absolutely loaded up with sugar.

There's not that much difference between the Canadian and US lifestyle. It's the health care and the welfare. People that are desperately poor eat a lot of high fat foods because they're cheap.

quote:
I agree, but it is not some "right" that you must be afforded. When cities get in budget crunches they suspend bus services. When an interstate needs repair, they close it. It is a service, which becuase society is capable of supporting it they do so as a service to the public


Sure, I agree. Questions about entitlements come before all this stuff. I think the wheelchair ramps are pretty close to a clear case of entitlement though, don't you?

Patroklos is offline Patroklos
Warlord
Back home in good ole Norfolk VA
Dec 2001
time: 05:16
  Old Post 23-12-2004 09:45
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quote:
Sure, I agree. Questions about entitlements come before all this stuff. I think the wheelchair ramps are pretty close to a clear case of entitlement though, don't you?


The wheelchair ramps are a discrimination thing, and they do have a right to not be discriminated against.

I think I am missing what your saying about entitlements, please explain when you get a minite.

And I have been to Canada many a times, I stick by my lifestyles comments. I would venture to guess that most experts agree too, but I can't be arsed to look up a sourse.

Agathon is offline Agathon
Prince
Leafs 4TW!! - CPA
Dec 2002
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  Old Post 23-12-2004 09:49
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quote:
The wheelchair ramps are a discrimination thing, and they do have a right to not be discriminated against.


You can spin that argument further though. Why should people who are in poor health through no fault of their own be disadvantaged with regard to health care.

Re: entitlements. I suppose you have a conception of justice (equality, utilitarian, etc.) and then you just work out the way to come as close to that goal as possible.

Differing theories of justice will yield different results. But my point was that things that people think are questions of justice are often practical issues. For example, there is no "right" to free travel, we just want to make travel as easy and efficient as possible and if public funding is the solution, that's what we do. If it isn't, we don't. It's not a question of justice, but of efficiency.

Patroklos is offline Patroklos
Warlord
Back home in good ole Norfolk VA
Dec 2001
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  Old Post 23-12-2004 09:57
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quote:
Differing theories of justice will yield different results. But my point was that things that people think are questions of justice are often practical issues. For example, there is no "right" to free travel, we just want to make travel as easy and efficient as possible and if public funding is the solution, that's what we do. If it isn't, we don't. It's not a question of justice, but of efficiency.


I agree with that completely. My beef with SS and the like in that framing is that even if government health care is efficient than private, which is by no means a truth, it is imaterial because the government as a whole would be more efficient useing that money for something else.


quote:
You can spin that argument further though. Why should people who are in poor health through no fault of their own be disadvantaged with regard to health care.


No inequality as far as the government purposely treating classes of people different. I think ALL people deserve help with their basic health care (ie vaccines, ER stabilization, emergency response).

But health care is a consumer service. The inequality is based on wealth, and in my opinion anything beyond basic healthcare is a luxury. Welcome to capitalist society.

Now we can argue all day over what "basic" healthcare is.

Berzerker is offline Berzerker
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topeka, kansas,USA
May 1999
time: 23:16
  Old Post 23-12-2004 10:58
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Aggie -
quote:
If you want to stop this sort of free riding Berz, you will need an agency with the power to compel people to pay for the risks they expose others to. To be effective this agency will be suspiciously like a government.


I'm not the one citing "free riders" to justify legalising robbery on a massive scale to pay for government. Why attribute this irrational fear of free riders to me when your side always brings it up?

quote:
I find it amusing that someone who believes in an extremely spurious doctrine of natural rights for which he can offer no reasonable argument should be laughing at another right claim that is also offered without argument


I wasn't laughing, I said there was no reason to be so hard on them. But I do offer a rationale for my belief in "natural rights" and you know it given how many times we've debated the issue.

quote:
We live in a contractarian society. In such societies people agree to disagree over most of what we would call moral issues, and leave the law to a few issues which most people agree on (like serious physical harm to other people).


That agreement is how we define morality, if ~everyone agrees "A" is immoral, then "A" is immoral by virtue of the strength of our agreement. The problem is some people want to ignore this and start defining rights based on lower standards, like "democracy" or majority rule, or personal taste. When this standard conflicts with the higher standard of ~universal desire, you end up with immorality masquerading as morality...

quote:
This means that people will pay tax that might go to fund a homosexual dance troupe or something else they find disagreeable. On the other hand, the homosexual dance troupers will probably be subsidizing church events (since religious organizations get hefty tax breaks). Neither likes what the other does, but if both can put up with the other leading their own lives, then both are happier.


They aren't leading their own lives, they are using government to rip each other off. And not surprisingly, "The Land of the Free" now has millions of laws because people like to attach strings to how others behave (image a puppeteer) when they're footing the bill. Universal healthcare means more laws about what we can and cannot do so that we don't "cost" the system money.

quote:
This is how our societies are organized, and there's a spectacularly good reason for it. We cannot achieve many of our goods without collective action, and the larger a society gets the more diverse the opinions of its members on what constitutes the good life grow.


The competition for survival and resources drives evolution, not Marxism.

quote:
In the old days this was solved by the law siding with the majority and persecuting the infidels. But this doesn't work. So contractarian societies developed in which everyone is expected to contribute and receives the benefit of not having the state intefere in their sex life or their religious life unless they are harming others.


Then your earlier assertion that we live in a contractarian system (social contract?) is wrong, we have all sorts of laws that restrict people when they aren't harming others.

quote:
Of course there will be problems with any sort of economic organization. I get annoyed that my phone bill costs what it does because the phone company flies its executives off to Hawaii for "motivational sessions".


There is a difference, in the marketplace I can seek businesses that show better fiscal sanity. We don't have that option with Congress controlling our lives.

quote:
For example, some government programs are inefficient (not all - public health care is actually a lot less bureaucratic than private systems) but if those programs provide something that people really need and at an acceptable cost and which the market would either fail to provide or provide at a massively inflated cost, it is worth putting up with the inefficiency.


The inefficiency we see in health care was caused by government. Wage and price controls during WWII started the practice of businesses affording health care packages to employees and the 3rd party payer system was born. And claiming the government bureaucracy is efficient ignores that government programs put alot of the burden on doctors who've become flooded with government paperwork. It ain't efficient for them to spend their resources complying with all the federal and state laws dealing with government run health care programs. Our family doctor had to join an HMO because of all the paperwork he was dealing with from government amd insurance companies.

quote:
Why would a road owner care about that?


All sorts of reasons, he uses the road too. He wants his road to be safe for others and insured drivers are better than uninsured drivers. If he attracts more motorists by requiring insurance, he has made a wise business move. But the owners of public roads are the voting taxpayers and they've required insurance, so why does that need further explanation?

quote:
The road owner is not responsible for people who have accidents on his road. If they damage the road, they have to pay him, but he owes nothing to the other people they hit - and to force him to would violate your conception of his rights.


Where did I say I would force him? I said the owner gets to decide.

quote:
If I owned a road I would expressly state that I was not responsible for accidents due to bad driving, since I would want more people to use it and it doesn't bother me if they are insured or not.


Then that's a business decision you will have to make, what's your point?

quote:
Of course you could argue that insured people would pay more to drive on roads that only allowed the insured, but that would involve a ridiculously inefficient amount of redundant road building, involving two different systems of roads.


People aren't going to build roads they don't need, that's the function of government.

quote:
More to the point, it would be extremely difficult to check who was insured and who was not. In a libertarian society people are going to object to having their cars bugged.


A sticker works now.

quote:
So people will attempt to free ride by driving without insurance or by being underinsured, knowing that if they hit someone else whom they can't afford to pay, the other person will just have to suck it up.


They do sell insurance to people to cover getting hit by the unisnured.

quote:
You can either go through the expensive rigmarole of trying to work out who is insured and who isn't, or you can force people to take responsibility for themselves by having the government pass a law that you cannot drive uninsured on pain of jail time.


And that's fine when the roads are public. You're trying to use this argument in a thread about SS and other "social contract" programs the left wants that violate the principle of ownership used in the public road example.

chegitz guevara is offline chegitz guevara
King
Ft. Lauderdale, FL Communist Party of Apolyton
Jun 2000
time: 00:16
  Old Post 23-12-2004 10:58 Visit chegitz guevara's homepage!
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quote:
Originally posted by Berzerker
How do "democrats" feel about letting voters earmark their taxes so they won't be forced to fund what they find immoral?


I think they'd feel pretty good about it, since Demcrats pay more in taxes. They could really screw the Red States.

chegitz guevara is offline chegitz guevara
King
Ft. Lauderdale, FL Communist Party of Apolyton
Jun 2000
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  Old Post 23-12-2004 11:00 Visit chegitz guevara's homepage!
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quote:
Originally posted by Patroklos
For some reason people assume medical care to be a right as opposed to the consumer service it is.


Most people assume health care is a right. That makes it a right. A right is what people say a right is. Rights don't exist independently of human beings, society, and social agreement.

Berzerker is offline Berzerker
Emperor
topeka, kansas,USA
May 1999
time: 23:16
  Old Post 23-12-2004 11:18
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quote:
Most people assume health care is a right. That makes it a right. A right is what people say a right is. Rights don't exist independently of human beings, society, and social agreement.


Most people don't assume that, but if 80% of the people say they have a right to enslave 10% of the population ("them"), would that create a right to slavery?

Odin is offline Odin
Prince
Biology Nerd at Minnesota State University Moorhead
Sep 2000
time: 23:16
  Old Post 23-12-2004 11:23
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quote:
Originally posted by Berzerker


Most people don't assume that, but if 80% of the people say they have a right to enslave 10% of the population ("them"), would that create a right to slavery?


Technically, yes

Note: don't start flaming me. That does not mean I approve of slavery. I am of the "society creates rights" school.

el freako is offline el freako
Prince
Bristol, European Union
Oct 1999
time: 05:16
  Old Post 23-12-2004 12:07
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quote:
Originally posted by Patroklos

That has nothing to do with their inferior health care system, it is because they have a healthier lifestyle.


Or because their health system is not exhorbitantly expensive?

Where you aware that Canada's government spends 6.7% of GDP on fairly universal healthcare but the US government spends 6.6% of it's GDP on healthcare for the poor, old and government employees?

Source: OECD

Urban Ranger is offline Urban Ranger
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May 1999
time: 13:16
  Old Post 23-12-2004 12:36
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quote:
Originally posted by Berzerker
Most people don't assume that, but if 80% of the people say they have a right to enslave 10% of the population ("them"), would that create a right to slavery?


Slavery is quite a giant leap from universal healthcare.

Agathon is offline Agathon
Prince
Leafs 4TW!! - CPA
Dec 2002
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  Old Post 23-12-2004 13:21
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quote:
Originally posted by Berzerker
Aggie -

I'm not the one citing "free riders" to justify legalising robbery on a massive scale to pay for government. Why attribute this irrational fear of free riders to me when your side always brings it up?


Because it is an established economic phenomenon. I doubt there is a first year economics course in which you don't learn about them. It's not some invention of the left, but an established fact.

For some activities governmental intervention is the only thing that can stop the free riding problem. The reason is quite simple, people wish to get as much as they can for as little as possible. Free riding in certain circumstances is prevented by markets, but other kinds of free riding are created by them. A society that adheres to an austere version of capitalism will be plagued with such problems. We are plagued with them now, but it would be worse if the government lost its power to engage in coercive taxation because we would then lose the only effective means of solving certain collective action problems.

Taxation just represents that portion of our incomes that we spend collectively, instead of individually. The government by and large does not waste money, but spends it on things that we need, like roads and the police. But it isn't really the government spending it, we spend it. We club together and buy police, because that is the most efficient way to do it.

Same goes for the fire department. Again, the reason is that if we left it up to voluntary contributions it would be underfunded because people would try to free ride. Think about the fire department. It's all very well for them only to put out fires in houses that have paid, but often, to avoid massive fires destroying the houses of payers, they have to put out fires in the houses of non-payers or protect the houses of non-payers from catching fire.

What this means is that it is worthwhile letting all the other people pay for the fire department because there is a good chance they'll put out the fire at your place to stop it spreading. The people who pay for fire protection create a positive externality which others can take advantage of at no cost. That means it is rational not to pay. What usually happens in these situations is that very few people pay the fire department gets underfunded and the fire risk goes up.

The obvious solution is to allow an authority the power to force people to pay for their own fire protection. This makes sure that no-one can free ride on any externalities. The result is that we get a proper fire department and everyone is happier and more secure. Sometimes we are just better off delegating certain decisions to a collective authority. Again, the reason is that individual incentives do not necessarily align with collective incentives. Sometimes if everyone does what is in their own interest, everyone ends up worse off. The vast majority of coercive structures in our society are designed to prevent this happening.

This is such an obvious feature of our societies that we often don't notice it, but it is there nonetheless.

If you are going to do away with coercive taxation, then you need to explain how such collective action problems will be solved. You can't pretend they don't exist, because they are so ubiquitous (think of noise control laws, dog catchers and the like for some mundane examples).

That's not to say that some modified form of Libertarianism couldn't solve these problems, but the puritanical opposition to collective action and taxation has to go, otherwise you cannot solve the problem.

You can't appeal to the market either. The market works by exactly the same principle if you think about it. It's just in that case it produces a collectively positive outcome (the invisible hand).

quote:
I wasn't laughing, I said there was no reason to be so hard on them. But I do offer a rationale for my belief in "natural rights" and you know it given how many times we've debated the issue.


Sorry, I've never quite been able to work out what it is.

quote:
That agreement is how we define morality, if ~everyone agrees "A" is immoral, then "A" is immoral by virtue of the strength of our agreement. The problem is some people want to ignore this and start defining rights based on lower standards, like "democracy" or majority rule, or personal taste. When this standard conflicts with the higher standard of ~universal desire, you end up with immorality masquerading as morality...


It's generally fallacious to infer from "everyone thinks A is right" to "A is right". Almost nobody really believes that what the majority thinks is automatically right - the popularity of films which say the opposite should be enough to dispel that idea.

On the other hand, you cannot infer from "I think A is right" to "A is right" either. The problem is that we do not have a good account of moral knowledge, if there is such a thing.

But even if we did, there is the practical problem of getting everyone to believe your theory. It is almost impossible to get universal agreement about many moral issues, even with the most sophisticated tools of logic and argument. That's why we have democracy to do it. Sure, it may produce silly results sometimes, but no-one seems to have come up with a better system that will work in the kind of society we have right now.

quote:
They aren't leading their own lives, they are using government to rip each other off. And not surprisingly, "The Land of the Free" now has millions of laws because people like to attach strings to how others behave (image a puppeteer) when they're footing the bill. Universal healthcare means more laws about what we can and cannot do so that we don't "cost" the system money.


Sure, it means more laws restricting what we can do. But these laws are actually to our advantage because they are laws that prevent free riding. Universal healthcare is just another kind of insurance. In order to prevent all the problems that arise from voluntary insurance schemes and the massive bureaucratic overload that private schemes generate, people give up the freedom to choose what to do with a certain amount of their income because they realize that they will be better off in the end if they do, because their healthcare will be cheaper, and everyone will have access to it, which will help prevent things like epidemics from starting.

quote:
The competition for survival and resources drives evolution, not Marxism.


Who mentioned evolution? The competition for survival and resources often drives us into a state of nature where life is nasty brutal and short.

Why do you think moral behaviour evolved? Not just because people were afraid of punishment, but because groups that exhibited a degree of selfless behaviour had a survival advantage. If you think about it, if everyone tried to get everyone else to do everything for them all the time, nothing would get done. If people didn't have a reasonable expectation that others would share, no-one would survive.

This is why moral restraints tend to be sufficient in small groups. It's when we don't know everyone and can't build up trust that we need things like the state.

quote:
Then your earlier assertion that we live in a contractarian system (social contract?) is wrong, we have all sorts of laws that restrict people when they aren't harming others.


We do have some laws that are bad. These are relics from an earlier conception of governance, the perfectionist theory. That is the understanding of politics that informs most Ancient and Medieval political theory. The idea is that there is one perfect form of virtue, and the function of politics is to make sure everyone lives up to it by any means available. In the past these means included things like burning heretics, so it's not an option for us. Some of our law is still informed by the perfectionist theory.

Many drug laws are based on this idea. The contractarian understanding of drug laws is that they can only be enforced when they cause harm to others. That's why it is a good idea to ban drugs that turn people into criminal lunatics, or which render them a massive burden to those around them. It's also why many people support marijuana law reform, because marijuana seems not to do any real harm if taken responsibly. Of course there are plenty of latter day perfectionists who just think it is immoral to get high, but these are the same sort of people who think sexual pleasure is immoral.

quote:
There is a difference, in the marketplace I can seek businesses that show better fiscal sanity. We don't have that option with Congress controlling our lives.


It's called a vote. The US is different because it has such an antiquated and patrician system of government. In New Zealand we have made it really easy to chuck out governments we don't like. We have elections every three years and proportional representation. The latter is crucial because it means that there is a reasonable prospect of political parties dying (because you don't have to choose between two). The result is that New Zealand has had for the past six years the best government I can remember. Minorities who are in coalition with the government (like the Greens and the moderate Christians) have managed to get some of their legislation passed (as a price for supporting the government) and their supporters are a lot happier. It's now actually worth voting, no matter where you live and PR means that no-one party can effectively monopolize power. It means that politicians actually have to work at achieving consensus (or they will be punished by the voters for being useless).

In any case, all the big businesses I know of waste money like this. It doesn't sound like fiscal sanity to me.

quote:
The inefficiency we see in health care was caused by government. Wage and price controls during WWII started the practice of businesses affording health care packages to employees and the 3rd party payer system was born.


And how many Americans had decent healthcare before that? The welfare systems in advanced countries post WWII are the single biggest factor in the increase in the general health of the population of those countries.

quote:
And claiming the government bureaucracy is efficient ignores that government programs put alot of the burden on doctors who've become flooded with government paperwork. It ain't efficient for them to spend their resources complying with all the federal and state laws dealing with government run health care programs.


I never said they were perfect, just better than private systems. Often reform is required.

quote:
Our family doctor had to join an HMO because of all the paperwork he was dealing with from government amd insurance companies.


HMOs are a response to the failure of individual private health insurance. The massive overcharging by doctors and spiralling medical costs was alleviated by creating a corporation which could have effective oversight of costs (and wouldn't have to worry about charging people for every last aspirin they had - which created massive overhead. It's simpler for the HMO to buy aspirin in bulk and give it out to people who need it and factor the total cost into premiums, than it is to make sure you charge each individual for the number of aspirins they had.

Government healthcare in New Zealand and Canada is basically a giant HMO without the profit motive screwing things up. It works. We're better off than you guys in this regard. You are paying too much and getting too little.

quote:
All sorts of reasons, he uses the road too. He wants his road to be safe for others and insured drivers are better than uninsured drivers.


There's no reason to believe that. Insurance can have the effect of making people less careful. That's why they have no claims bonuses.

quote:
If he attracts more motorists by requiring insurance, he has made a wise business move.


If... but meanwhile, we spend far too much money building two road systems.

quote:
But the owners of public roads are the voting taxpayers and they've required insurance, so why does that need further explanation?


I don't understand. Insurance is required in part to make sure that if you have an accident, the other person does not lose out because you're a bum.

quote:
Where did I say I would force him? I said the owner gets to decide.


And will decide whatever makes him the most money, this has nothing to do with insurance. He doesn't have to pay for accidents.

quote:
People aren't going to build roads they don't need, that's the function of government.


Yes they are if we adopt different schemes for insured and non-insured drivers. There will be demand for two different sets of roads, since the insured want to keep away from the uninsured. As it happens, it is cheaper to build one big road than two small ones. Your scheme will result in resources being wasted on unnecessary road building.

quote:
A sticker works now.


Not in Toronto it doesn't. It still doesn't solve the problem of two road systems.

quote:
They do sell insurance to people to cover getting hit by the unisnured.


Yes, but the insured pay for that, the uninsured don't. This sort of scheme makes free riding even more likely.

quote:
And that's fine when the roads are public. You're trying to use this argument in a thread about SS and other "social contract" programs the left wants that violate the principle of ownership used in the public road example.


No they don't. They're the same.

We need roads, so what is the most efficient way to build them? Generally it is through gas taxes collected by the government who then build roads.

We need health care, what is the most efficient way of supplying that? General taxation collected by the government, which then acts as our insurer.

Your argument against healthcare would be better if it wasn't contradicted by the facts that state healthcare is cheaper and better overall. Even in countries like New Zealand, where people can purchase additional coverage from private insurers (who were really annoyed when a government under the previous system cut health care, because demand for their services skyrocketed and they had to massively increase their premiums).

Berzerker is offline Berzerker
Emperor
topeka, kansas,USA
May 1999
time: 23:16
  Old Post 23-12-2004 14:34
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UR
quote:
Slavery is quite a giant leap from universal healthcare.


The comparison is not slavery to universal health care, the comparison is a right to health care based on what a large majority says and a right to enslave others based on what a large majority says. I'm showing why rights are not based on majority rule.

Odin
quote:
Technically, yes

Note: don't start flaming me. That does not mean I approve of slavery. I am of the "society creates rights" school.


Nazi society created a right to slaughter Germans.

Spiffor is offline Spiffor
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CPA - Evil Clone brigade
Nov 2001
time: 06:16
  Old Post 23-12-2004 14:37
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quote:
Originally posted by Kuciwalker
And even if we could, in theory, why should we dedicate our entire society to providing every possible bit of health care?

You are already dedicating 15% of your GNP to health care. You are the country that spends (proportionally and absolutely) the most on its health, by far. Only that these 15% are mostly private spending, while other countries tend to have public health spending.

You may want to consider an actual public healthcare system, as it could help you to have more reasonable expenditures. With a public healthcare system, your society as a whole would dedicate far less money than it is currently doing.

Sikander is offline Sikander
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Boulder, Colorado, United Snakes of America
Jan 2000
time: 22:16
  Old Post 23-12-2004 14:50
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quote:
Originally posted by Spiffor

You are already dedicating 15% of your GNP to health care. You are the country that spends (proportionally and absolutely) the most on its health, by far. Only that these 15% are mostly private spending, while other countries tend to have public health spending.

You may want to consider an actual public healthcare system, as it could help you to have more reasonable expenditures. With a public healthcare system, your society as a whole would dedicate far less money than it is currently doing.


Stop with the crazy talk! If we reform health care someone might eliminate my job, and then I won't get paid to post on Apolyton.

Spiffor is offline Spiffor
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CPA - Evil Clone brigade
Nov 2001
time: 06:16
  Old Post 23-12-2004 15:13
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quote:
Originally posted by Sikander
Stop with the crazy talk! If we reform health care someone might eliminate my job, and then I won't get paid to post on Apolyton.

I thought you were workin in a community hospital or something? Unless your policy is to make the customer sicker than he is, so that he comes to the hospital more often, I don't see how a health care reform would mean fewer ill people coming at your place

Sikander is offline Sikander
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Boulder, Colorado, United Snakes of America
Jan 2000
time: 22:16
  Old Post 23-12-2004 15:18
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quote:
Originally posted by Spiffor

I thought you were workin in a community hospital or something? Unless your policy is to make the customer sicker than he is, so that he comes to the hospital more often, I don't see how a health care reform would mean fewer ill people coming at your place


Well if we reduce the amount of money that goes into healthcare, then that means we will also reduce the number of people who work in healthcare. Though in all likelihood many of those who will lose their jobs will be in the insurance industry and its mirror bureacracies in hospitals and medical offices. My job is probably safe.

Spiffor is offline Spiffor
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  Old Post 23-12-2004 15:21
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quote:
Originally posted by Sikander
Well if we reduce the amount of money that goes into healthcare, then that means we will also reduce the number of people who work in healthcare. Though in all likelihood many of those who will lose their jobs will be in the insurance industry and its mirror bureacracies in hospitals and medical offices. My job is probably safe.

I think so. Besides, the main reason why health care is so fricking expansive in the US is because pretty much everything is for-profit. Which means that the first victim of a health care reform would be profits (by insurance xompanies, pharmaceutical industry, private hospitals) more than the jobs.

Berzerker is offline Berzerker
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topeka, kansas,USA
May 1999
time: 23:16
  Old Post 23-12-2004 15:33
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Aggie
quote:
Because it is an established economic phenomenon. I doubt there is a first year economics course in which you don't learn about them. It's not some invention of the left, but an established fact.


You argued that I was concerned with free riders when I'm not, that concern is yours. I don't care if some guy in the neighborhood benefits from the police my neighbors and I pay for. According to your argument, the USA would be morally right to force European countries to pay us because Europe got a free ride during the cold war.

quote:
For some activities governmental intervention is the only thing that can stop the free riding problem. The reason is quite simple, people wish to get as much as they can for as little as possible. Free riding in certain circumstances is prevented by markets, but other kinds of free riding are created by them. A society that adheres to an austere version of capitalism will be plagued with such problems. We are plagued with them now, but it would be worse if the government lost its power to engage in coercive taxation because we would then lose the only effective means of solving certain collective action problems.


Liberals don't care about free riding, they endorse the free lunch society. So why do liberals care about free riders under libertarianism when there are far fewer than under a quasi-socialist system? Because there are fewer free riders under libertarianism and liberals endorse the free lunch society. I think its for left wingers to feign concern over free riders given their ideological imperative to create a welfare state.

quote:
Taxation just represents that portion of our incomes that we spend collectively, instead of individually.


It represents time and labor forcibly taken from other people usually under the threat of injury or death. Give us your money or else...

quote:
The government by and large does not waste money, but spends it on things that we need, like roads and the police.


Doesn't waste it? Compared to whom?

quote:
Same goes for the fire department. Again, the reason is that if we left it up to voluntary contributions it would be underfunded because people would try to free ride. Think about the fire department. It's all very well for them only to put out fires in houses that have paid, but often, to avoid massive fires destroying the houses of payers, they have to put out fires in the houses of non-payers or protect the houses of non-payers from catching fire.


That's no different than the police example, contrary to what you guys think most people will pay taxes to support a fire department if they are free. Every time we debate this issue you make these assertions backed up only by claims about "economic models". Btw, we have a volunteer fire dept here.

quote:
What this means is that it is worthwhile letting all the other people pay for the fire department because there is a good chance they'll put out the fire at your place to stop it spreading.


So no one would buy fire insurance because there's a good chance their house wont burn down? How can you depend on economic models that ignore how people really behave?

quote:
The people who pay for fire protection create a positive externality which others can take advantage of at no cost. That means it is rational not to pay.


There is always a cost, the cost of pissing people off to the cost of not getting help in case of fire.

quote:
What usually happens in these situations is that very few people pay the fire department gets underfunded and the fire risk goes up.


And people react accordingly with increased funding.

quote:
The obvious solution is to allow an authority the power to force people to pay for their own fire protection.


That is an immoral solution.

quote:
This makes sure that no-one can free ride on any externalities.


What if I don't want your fire protection? I get punished? How is this any different than Mafia "protection"?

Sikander is offline Sikander
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  Old Post 23-12-2004 16:31
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quote:
Originally posted by Spiffor

I think so. Besides, the main reason why health care is so fricking expansive in the US is because pretty much everything is for-profit. Which means that the first victim of a health care reform would be profits (by insurance xompanies, pharmaceutical industry, private hospitals) more than the jobs.


I honestly don't think that profits are the problem. It's inefficiency that really eats up the money. Having numerous insurance companies with numerous policies for instance creates enormous mirror bureacracies to respond. A huge amount of the waste is actually used to provide what everyone in Europe thinks that we don't provide, which is healthcare for those without insurance. We do provide it, but it is done very inefficiently. We provide emergency care in place of preventative care, and we jack up the rates of those who actually pay their bills by about 100% in order to pay for it.

The public health sector is little better honestly. The vast majority of the money there is spent keeping old people alive rather than giving children their best chance to prosper. This is exactly backwards from a utilitarian standpoint. Money spent on children will save more money in the longrun and will yield real dividends in increased productivity for years. Money spent on keeping retired people alive is much less likely to provide a tangible financial benefit to society, whatever the moral benefit might be. It seems much wiser to invest in children as our first priority, and to parlay the financial benefits that this brings for the general good. Also, children are the most likely ones in our society to live in poverty, while the elderly are the wealthiest demographic. Why are they the only ones with an entitlement to healthcare? They should be last in line.

Back to profits. Going to a government healthcare system would probably cut administrative costs in half, which is fine. It would cost a lot of jobs though, which would result in a fair amount of short term pain, and it would further strain the shortage of health care workers by increasing their workload. In the long run this will probably provide a benefit to society in general, but there will be other considerations which will reduce this advantage. Research will take a hit, which will in some ways provide a competetive advantage to America economically in reducing the cost of our labor, but will harm the world more generally as it will not be able to take advantage of the free ride it gets as Americans no longer will pay as much for research that in the long run benefits everyone.

For political reasons any change will almost certainly have to occur in stages. Without using a "divide and conquer" strategy the various stakeholders in the current system will be able to thwart any attempt to make wholesale changes. This can be an advantage though. The government could pick the low hanging fruit and realize the most benefit for the least money, which could produce tangible benefits for society while allowing programs to evolve rather than having to succeed spectacularly immediately. This will also reduce the political power of the champions of the status quo. I'd prefer a system which ends up as a hybrid public / private system, with strong participation by not-for-profit entities where the market fails people. If we ran insurance like we run credit unions today we'd see far less of a demand for a government health care system and all the risks of poor service and financial disaster that it entails.

Spiffor is offline Spiffor
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  Old Post 23-12-2004 16:39
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Interesting read. Thanks for the post

pchang is offline pchang
King
Cupertino?
Aug 1999
time: 05:16
  Old Post 23-12-2004 18:35
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Places like the UK with "universal" health care really have a two tier system. Poor people rely on "universal" health care for basic needs. They can even get things like hip replacements, but there are long waiting periods, because the number of applicants far exceeds the capacity of the system. In fact, this is the case for most things. Anyone with sufficient money pays for private insurance which operates much the way the US system does. These people get whatever they require and with much shorter waiting periods.

 
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